High Salt Promotes Inflammatory and Fibrotic Response in Peritoneal Cells
, Csenge Pajtók 1, Apor Veres-Székely 1,2, Beáta Szebeni 1,2, Csenge Szász 1, Péter Bokrossy 1, Réka Zrufkó 1, Ádám Vannay 1,2, Tivadar Tulassay 1,2 and Attila J. Szabó 1,2
Round 1
Reviewer 1 Report
In this manuscript, Dr. Pap and colleagues explored the mechanisms behind salt-induced peritoneal fibrosis. Overall, this is a nicely done research with undoubtedly important findings. I only have a few questions:
1. I think it is important to clarify whether high salt concentrations (and mannitol) were introduced to those cells since the beginning or during a specific timing in the experiment.
2. I am wondering whether the release of the inflammatory markers and other fibrosis-inducing substances are actually due to the rapid change of the osmolarity? What if the authors induce the high salt concentrations incrementally? Please conduct an experiment to explore this possibility.
3. I don't see experiments and discussion about high salt intake, RAAS activation/suppression and peritoneal fibrosis. Why? Is it not important?
4. This recent review article can be included in the discussion as well (PMID: 37445436)
No comment
Author Response
Dear Reviewer 1.
Please see the attachment.
Sincerely,
Dr. Domonkos Pap
Author Response File: 
Author Response.pdf
Reviewer 2 Report
Thank you for the opportunity to review this manuscript. There are some technical considerations to take into account to improve its technical quality.
Regarding the title, check for the spelling of “Patomechanism” ( pathomechanism), also, as your experimental model does not include salt intake as a variable, change the title to a more specific one.
In the introduction section, add some reference stating the direct relationship between Dietary sodium intake and osmotic increase in the peritoneum
In the Materials and Methods section, review the order in which every section should be addressed (i.e. Materials and methods should go before results).
On line 357, it is stated “primary mesothelial cells HPMCs were isolated from the peritoneal biopsy of 14 years old patient with congenital kidney disease without history of PD” please specify the congenital kidney disease, in order to clarify that it is not a congenital kidney disease in which fibrosis plays a role on its own.
On line 372 and 373 specify that there were taken with no previous peritoneal fibrosis (it is expected since they were taken from peritoneal biopsy specimens obtained when 375 inserting a Tenckhoff catheter, but is best to specify).
On line 398, check for the spell of the word “gradi-ent”
In the statistical analysis, specify the way you assessed the normality of the data analyzed, as it is an important fact before choosing further statistical management of the data.
Only minor mistakes to be corrected
Author Response
Dear Reviewer 2,
Please see the attachment.
Sincerely,
Dr. Domonkos Pap
Author Response File: 
Author Response.docx
Round 2
Reviewer 1 Report
Thanks for the response. I have no further comments
nothing
